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Xerri de Caro J.1, Farrugia F.1, Scerri J.1
1University of Malta, Msida, Malta
Background: Handball is a sport commonly practiced in Europe and is gaining popularity in Malta. Similar to other sports, handball athletes are at risk of injury and good screening leads to the prevention of overuse shoulder injuries. Not only are shoulder injuries in handball common, but it would appear that the study of these injuries is very limited, if present at all on the Maltese scene. This study was developed to examine the prevalence of shoulder overuse injuries in local handball players to discover the risk of developing such injuries and also to learn more about the predisposing factors that might lead to such overuse injuries.
In this exploratory study, active members of the Malta Handball Association (MHA) were asked to complete a questionnaire following which those aged between eighteen (18) and forty (40), underwent a physical examination that included an evaluation of the Glenohumeral Internal Rotation Deficit (GIRD), which is a 20° lag of shoulder internal rotation (Bukhart, Morgan and Kibler, 2003) that is known to be a precursor to overuse shoulder injuries in such an overhead throwing sport. The findings of this study were analysed and compared to current literature.
In this exploratory study, active members of the Malta Handball Association (MHA) were asked to complete a questionnaire following which those aged between eighteen (18) and forty (40), underwent a physical examination that included an evaluation of the Glenohumeral Internal Rotation Deficit (GIRD), which is a 20° lag of shoulder internal rotation (Bukhart, Morgan and Kibler, 2003) that is known to be a precursor to overuse shoulder injuries in such an overhead throwing sport. The findings of this study were analysed and compared to current literature.
Purpose: This study aimed at examining the prevalence of shoulder overuse injuries in Maltese handball players and to discover any associations between GIRD finding and factors such as BMI, age, gender, training sessions per week, years of training, level of play, position of play and practice of other sport.
Methods: Online questionnaires were used to collect demographic data from all active handball players for season 2014/2015. The data collected included age, gender, contact details, history of shoulder surgeries, injuries and pain, seasons played, position of play, level of play, involvement in another sport, minutes of training per week and arm dominance. Once the questionnaires were analysed, GIRD data was collected from 46 eligible handball players using a bubble inclinometer. The Independent Sample T-Test and the 1-way Analysis of Variance were used to analyse results.
Results: Three overarching themes emerged from the data;
Barriers to practice based education in a seven day model of working
Challenges faced in practice based learning by physiotherapists in a seven day model of working
Changes undertaken in practice based education by physiotherapy during the transition to a seven day model of working
Using the metaphorical image of a traffic light system; the red light or barriers were interpreted to be stumbling blocks that need to be overcome in order for the physiotherapy profession to move forward in practice education in a seven day model of working and included how inconsistent working patterns affected learning and development. Challenges, the amber light, made participants pause and consider their actions or the impact it may have on practice before moving forwards. This theme related to adjusting to new ways of working which included the impact of shift work, a different approach to supervision and how the environment was different at weekends. Finally, the green light, changes that have already occurred. This theme related to gaining more than just skills and knowledge and that it was a real life experience, preparing them for future employment and career.
Using the metaphorical image of a traffic light system; the red light or barriers were interpreted to be stumbling blocks that need to be overcome in order for the physiotherapy profession to move forward in practice education in a seven day model of working and included how inconsistent working patterns affected learning and development. Challenges, the amber light, made participants pause and consider their actions or the impact it may have on practice before moving forwards. This theme related to adjusting to new ways of working which included the impact of shift work, a different approach to supervision and how the environment was different at weekends. Finally, the green light, changes that have already occurred. This theme related to gaining more than just skills and knowledge and that it was a real life experience, preparing them for future employment and career.
Conclusion(s): When comparing the current findings to the literature review, it was concluded that male athletes with a longer career in handball would appear to have a greater predisposition to GIRD and therefore a greater risk of injury.
Implications: The results from this study may guide physiotherapists working with handball players/teams to identify the athletes at increased risk of developing GIRD and to address this early on through preventative rehabilitation strategies and/or specific training programmes.
Funding acknowledgements: None
Topic: Sport & sports injuries
Ethics approval: Physiotherapy Department;
All authors, affiliations and abstracts have been published as submitted.
